Objective To improve the diagnosis and treatment of xanthogranulomatous pyelonephri- tis(XGP).Methods The clinical data of 18 cases(5 males and 13 females;mean age,47 years)with XGP were analyzed.Of them,6 had the lesion on the left,and 12 on the right.Before operation,XGP was mis- diagnosed as renal calculus with hydronephrosis in 4 cases,ureteral calculus with severe hydronephrosis in 3 cases,renal tuberculosis in 3 cases and renal carcinoma in 8 cases.Results Of the 18 cases,7 were diag- nosed to have XGP by frozen section during operation and 11 cases had a definite diagnosis by pathological examination after nephrectomy.After a follow-up of 6-124 months,no recurrence was observed in all these 18 cases.Conclusions Preoperative diagnosis of XGP is difficult.This disease is clinically characterized by foam cells in urine smear,low-density value of kidney CT and ineffective antibiotic therapy.Combined a- nalysis of clinical data and improvement of clinical recognition of XGP is the key to avoiding delayed diagno- sis or misdiagnosis of XGP.

OBJECTIVETo evaluate the value of ascitic bacterial 16S rRNA gene determination in the rapid diagnosis of spontaneous bacterial peritonitis (SBP).

METHODS16S rRNA gene from bacterial DNA in ascites was determined by quantitative fluorescent polymerase chain reaction (PCR) in 76 patients with suspected SBP and 6 patients with non-infectious ascites. The results were compared with those obtained from bacterial culture.

RESULTSThe positive rate of SBP was 22.4% among patients detected with ascitic bacterial 16S rRNA gene determination-based quantitative fluorescent PCR, which was significantly higher than that (7.9%) in patients only received bacterial culture (P<0.05). In addition,in 6 patients with non-infectious ascites,both the 16S rRNA gene determination-based quantitative fluorescent PCR and bacterial culture showed negative results.

CONCLUSIONS16S rRNA gene determination-based quantitative fluorescent PCR can be an effective tool for the rapid diagnosis of SBP. It is more sensitive than the bacterial culture.

Adult ; Aged ; Ascitic Fluid ; microbiology ; Bacterial Infections ; diagnosis ; DNA, Bacterial ; analysis ; Female ; Humans ; Male ; Middle Aged ; Peritonitis ; diagnosis ; microbiology ; RNA, Ribosomal, 16S

OBJECTIVETo evaluate the significance of determining ascitic bacterial 16S rRNA by quantitative PCR combined with microarray (PCR-microarray) in the diagnosis of spontaneous bacterial peritonitis (SBP).

METHODSAscitic bacterial 16SrRNA was determined by real time fluorescent quantitative PCR-microarray in 76 cases of suspected SBP and 6 cases of non-infectious ascites with chronic liver diseases. The results were compared with ascitic bacterial culture simultaneously.

RESULTSOf 76 ascitic samples, 17 were detected bacteria positive by PCR-microarray, including 8 Grams positive(G+) and 9 Grams negative(G-), which was higher than that by bacterial culture which had only 6 ascitic samples detected positive (all G-); the positive rates were 22.4% vs 7.9%, respectively (P < 0.01). The bacterial strains detected by both methods in 6 cases had a consistency with each other. No bacteria were detected in another 6 cases of non-infectious ascites with chronic liver diseases.

CONCLUSIONSDetermination of ascitic bacteria 16S rRNA by PCR-microarray has a higher specificity and sensitivity in the diagnosis of SBP as compared with the bacteria culture. Application of this novel method can not only accelerate SBP diagnosis but also stratify the different pathogens.

Adult ; Aged ; Ascitic Fluid ; microbiology ; Bacterial Infections ; diagnosis ; microbiology ; Female ; Humans ; Liver Cirrhosis ; diagnosis ; microbiology ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Peritonitis ; diagnosis ; microbiology ; Polymerase Chain Reaction ; methods ; RNA, Bacterial ; isolation & purification ; RNA, Ribosomal, 16S ; isolation & purification

OBJECTIVETo observe the differences in the cytokine levels in the serum and ascites caused by Gram-positive or Gram-negative bacterial infection in patients with multiple organ dysfunction syndrome (MODS).

METHODSThe cytokines in the serum and ascites of the patients were examined by enzyme-linked immunosorbent assay in 27 patients with MODS due to Gram-positive (n=13) or Gram-negative (n=14) bacterial infection at day 1.

RESULTSThe levels of LPS and TNF-a were higher in the patients with Gram-negative bacterial infection than in patients with Gram-positive infection (P<0.05), but the levels of IL-6, IL-8 and IL-10 remained comparable between the two groups (P>0.05).

CONCLUSIONTesting of LPS and TNF-a in the serum and ascites of patients with MODS caused by Gram-positive or -negative bacterial infection may help to identify the pathogens for peritonitis resulting in MODS.

Ascites ; metabolism ; Gram-Negative Bacterial Infections ; blood ; metabolism ; Gram-Positive Bacterial Infections ; blood ; metabolism ; Humans ; Interleukin-10 ; blood ; metabolism ; Interleukin-6 ; blood ; metabolism ; Interleukin-8 ; blood ; metabolism ; Multiple Organ Failure ; blood ; metabolism ; microbiology ; Serum ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; metabolism

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

Needle-sticking method has essential differences from stuck needle induced by acupuncture accident. This manipulation refers to the needle-sticking manifestation induced by twirling the needle in one direction after arrival of qi so as to tangle muscle fibers, which can combined with some compound methods such as trembling, shaking, flying, lifting, plucking, dragging and so on. It is effective for excessive syndrome, pain syndrome, arthralgia syndrome, etc. and with functions of promoting flow of qi and inducing qi to carry out stimulating circulation of channel-qi, promoting the needling sensation propagating along the channel and accelerating qi reaching to the affected region. Its main adverse reactions are pain, tissue damage and so on. The selection of needling instruments, the needling depth, the twirling intensities and location of forbidden or careful application must be paid attention in concrete practice.
Acupuncture Therapy ; adverse effects ; instrumentation ; methods ; Humans ; Medicine, Chinese Traditional ; Needles

OBJECTIVETo explore the factors that affect the recovery of consciousness in patients with disorders of consciousness following brain trauma.

METHODSWe analyzed the data of 114 patients with disorders of consciousness following brain trauma admitted for rehabilitation. Bilateral logistic regression analysis was used to explore the factors that affected the recovery of the patients' consciousness. A logistic regression model was established and the ROC curve was drawn to obtain the optimal threshold of the prognostic model.

RESULTSUnivariate analysis showed that vegetative state duration (P<0.001), CRS-R scores (P<0.001), hydrocephalus (P=0.037), hypertonia (P=0.034), central fever (P=0.035), paroxysmal sympathetic hyperactivity (PSH) (P=0.004), and epilepsy seizures were correlated with the recovery of consciousness. Logistic multivariate analysis showed that central fever (OR=3.493, P=0.044), vegetative state duration (OR=1.016, P=0.008), PSH (OR=4.223, P=0.034) and CRS-R scores (OR=0.640, P=0.002) all significantly affected the recovery of consciousness. The χvalue of the Hosmer-Lemeshow test was 10.214 (P=0.250), and the goodness of fit of this model indicated an outstanding fitting (c=0.91).

CONCLUSIONSThe presence of PSH is the one of the most important factor followed by centric fever to affect the outcome of patients with disorders of consciousness. A lower CRS-R score and a longer duration of vegetative state also predict a poor recovery of consciousness in these patients.

OBJECTIVETo explore the effects and the molecular mechanism of puerariae radix flavones (PRF) on acute myeloid leukemia cell line Kasumi-1 cells in vitro.

METHODSKasumi-1 cells treated by PRF for 48 hours were observed with Wright's and Hoechst 33258 dying. The apoptotic cells were analyzed by flow cytometry with AnnexinV/PI staining. The expression levels of bcl-2, Bim and Caspase-3/-8/-9 protein were assayed by Western blot and the AML1-ETO fusion gene was detected by real-time polymerase chain reaction.

RESULTSPRF could induce Kasumi-1 cells to apoptosis effectively. The proportion of apoptotic cells in 50, 200 and 500 µg/ml PRF treatment groups were (14.1 ± 0.8)%, (17.7 ± 1.3)% and (32.4 ± 1.4)%, respectively, and significantly higher than that of control \[(7.8 ± 0.7)%\]. The relative expression levels of the anti-apoptotic Bcl-2 protein were 0.85 ± 0.05, 0.62 ± 0.07 and 0.43 ± 0.05; the apoptotic Bim protein were 0.21 ± 0.06, 0.39 ± 0.04 and 0.75 ± 0.05; the caspase-3 and caspase-9 were 0.92 ± 0.04, 1.21 ± 0.07, 1.33 ± 0.04 and 0.35 ± 0.05, 0.53 ± 0.03, 0.69 ± 0.07, respectively. Compared to the blank control group, all these changes were significant (P < 0.01). Nevertheless, nearly no changes could be observed on the expression level of AML1-ETO fusion gene and caspase-8 protein.

CONCLUSIONApoptosis of Kasumi-1 cells induced by PRF might correlate to the down-regulation of Bcl-2 protein expression and the activation of caspase-3 and caspase-8 protein in the cells. It seemed that all these effects had no relationship with the AML1-ETO fusion gene.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Cell Line, Tumor ; Core Binding Factor Alpha 2 Subunit ; genetics ; metabolism ; Flavones ; pharmacology ; Humans ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Pueraria ; RUNX1 Translocation Partner 1 Protein

Objective To measure biomechanical parameters of the cornea after keratoconus and laser corneal refractive surgery by Scheimpflug noncontact tonometry (Corvis ST),and analyze the changes and differences in these parameters.Methods From April 2011 to November 2016,63 patients (96 eyes) with clinically diagnosed as keratoconus were selected as the keratoconus group,and 60 patients (120 eyes) underwent laser corneal refractive surgery between November 2016 to March 2017 were selected as postoperative cornea group,and totally 51 healthy person (102 eyes) who received physical examination during the same period were selected as healthy cornea group.Scheimpflug noncontact tonometry (Corvis ST) was performed to measure the length of appl 1,length of appl 2,velocity of appl 1,velocity of appl 2,maximum deformation amplitude,apex distance and radius of curvature in the three groups.Total comparison of biomechanical parameters was performed using ANOVA test among the three groups,while pairwise comparison was performed to analyze the difference of these parameters by SNK methods.Pearson or Spearman correlation analysis was applied to assess the differences in corneal morphological and biomechanical parameters.Results There was no significant difference in length of appl 1,length of appl 2 of the three groups (all P ＞ 0.05).And velocity of appl 1 in the keratoconus group was significantly higher than that of the healthy cornea group [(0.189 ± 0.230) m · s-1 vs.(0.151 ± 0.017)m · s-1] (P ＜ 0.05).As for velocity of appl 2,the keratoconus group was larger than the healthy cornea group,both which were larger than the postoperative cornea group,and the differences were significant (all P ＜ 0.05).And this was true of maximum deformation amplitude in the three groups,with the significant differences(all P ＜ 0.05).The apex distance in the keratoconus group was significantly longer than that in the healthy cornea group (P ＜ 0.05).The radius of curvature of the keratoconus group,postoperative cornea group and healthy cornea group were (5.696 ± 0.881) mm,(7.129 ± 0.681) mm and (7.012 ± 0.728) ram,respectively,which approached significant differences(all P ＜ 0.05).There was significant correlation between the anterior surface refractive power (Km) and apex distance and radius of curvature in the keratoconus group (r =-0.205,0.1 84;P =0.023,0.041),and maximum posterior surface elevation had a statistically significant correlation with velocity of appl 2,maximum deformation amplitude and radius of curvature (r =-0.579,-0.307,0.256,P =0.022,0.002,0.000).For the eyes in the postoperative cornea group,there were no significance correlation between the anterior surface refractive power (Km) and biomechanical properties (P ＞ 0.05),but significant correlation with length of appl 2 (r =-0.297,P =0.026).There were no significant correlation between maximum posterior surface elevation and biomechanical properties (P ＞ 0.05).Conclusion The corneal biomechanical parameters are decreased in eyes after keratoconus and laser corneal refractive surgery,and Corvis ST can become an auxiliary examination tool for earlier diagnosis of secondary keratoconus after corneal refractive surgery.

Through cluster multistage sampling,a resident group of 6 412 subjects with hypertension in the rural area of Liaoning province were recruited.According to IDF and NCEP-ATPm criteria the age-standardized prevalences of metabolic syndrome were 36.2%and 25.9%respectively.The prevalence of metabolic syndrome decreased with advancing age,but increased with rising of blood pressure.